has been unfortunately found, that although the accommodation provided in the ten District Asylums very considerably exceeds that which was contemplated by the Committee of 1817, it is very far from meeting the necessity of the case. The asylums were originally intended but for 1,220 patients; they now contain 2,028; various additions have been made to them [providing] for the reception of 264 patients; but the increased and rapidly increasing number of incurable cases have lamentably diminished the efficacy of these asylums as hospitals for the cure of insanity.159
The select committee noted that, for the most part, the ‘system of management adopted in the District Asylums’ was ‘very satisfactory and successful’, involving ‘a humane and gentle system of treatment’, with ‘cases requiring restraint and coercion not exceeding two per cent on the whole’.160 The select committee was, however, at pains to point out that the apparent success of Ireland’s District Asylums provided no reason for complacency, as there were various other institutions that presented cause for concern:
The House must not, however, imagine that the District Lunatic Asylums are the only establishments in which pauper lunatics are confined in Ireland. Besides Swift’s Hospital, which is supported by the private endowment of the eminent Dean of St Patrick’s, there are other public establishments provided for the custody if not for the cure of insanity, and which are supported by local taxation. Connected with some of the old Houses of Industry in Ireland, cells or rooms were provided for the insane. Local asylums still subsist at Kilkenny, Lifford, Limerick, Island Bridge, and the House of Industry in Dublin. With the exception of the last two, these miserable and most inadequate places of confinement are under the general authority of the Grand Juries, the funds for their support being raised by presentment or county rate. The description given of these latter most wretched establishments not only proves the necessity of discontinuing them as speedily as accommodation of a different kind can be provided, but also exemplifies the utter hopelessness, or rather the total impossibility, of providing for the due treatment of insanity in small local asylums. No adequate provision is made or is likely to be made, in such establishments, for the medical or moral treatment of the unfortunate patients; no classification; no employment; no sufficient grounds for air or exercise. Hence the necessity of a coercive and severe system of treatment. The chances of recovery, if not altogether extinguished, are at least reduced to their very lowest term.161
The select committee went on to demonstrate its point by citing specific evidence it received relating to conditions in Kilkenny, Wexford and Lifford. In the case of Wexford, the committee drew attention to the evidence of Dr Francis White, Inspector General of Prisons, who reported that ‘the state of the Wexford lunatics in the local asylum is most disgraceful; nothing could equal the state in which I found that asylum; it is part of the old House of Industry’:
The number amounted to fourteen males and seventeen females; the place was quite dilapidated; the yards gloomy; the dinner rooms equally so; the cells were the worst I ever saw. There were two patients under restraint, one of whom was chained to a wall. When I went to his cell, with the keeper and the medical officer, I asked to go in. The keeper said it would be dangerous and frightful to go in. However we went in. He was naked, with a parcel of loose straw around him. He darted forward at me, and were it not that he was checked by a chain which went round his leg, and was fastened by a hook to the wall, he would have caught hold of me, and probably used violence. I asked how it was possible they could allow a man to remain in such a state; they said they were obliged to do so, as the funds were so limited that they had not money to buy clothes for him, and that if they had clothes they would have let him out. Now, the consequence of this treatment was, that the man became so violent that his case was made tenfold worse. I went to another cell, and though the individual there was not chained, he was nearly in as bad circumstances as the other. One of the two was once a respectable person. Altogether, those two cases were the most frightful I ever witnessed; I could not describe the horror which seized me when I saw them.162
When asked if there was ‘any moral superintendence’ at the Wexford establishment, White was blunt: ‘There was both a male and female keeper, but they appeared to me totally unfit for the discharge of their duties’. There were similar problems with staffing at other locations. An appendix to the select committee report recounted that in Clonmel District Lunatic Asylum163 efforts to recruit appropriate staff were ‘a sad calamity’, and Dr James Flynn, manager, reported that ‘the majority of attendants had to be removed, after my appointment, for drunkenness, cruelty to and neglect of patients, and a total disregard for order and discipline’.164
To illustrate the difficulties faced, Flynn presented three examples of objectionable behaviour in Clonmel:
I visited the Female Refractory Ward, as usual, on 13th September 1841, and found a patient crying bitterly. I had before asked the reason, and received an indefinite reply; however, I examined on this day the cause, and found her arm had been broken for a period of four days, and no report whatever made by the nurse in charge.
I visited the Male Refractory [Ward] on the night of the 6th of October 1841, and found all the keepers of the House, save one, playing cards; the one not so occupied was stupidly drunk in an adjoining bath room.
I visited the Female Tranquil Ward on the night of the 19th December 1841, at 10 o’clock, and found the assistant nurse perfectly intoxicated.
Having considered evidence relating to all places of confinement of the ‘lunatic poor’ in Ireland, ranging from District Asylums to prisons, the 1843 select committee made a series of recommendations:
1.The necessity of discontinuing, as soon as practicable, the committals of lunatics of gaols and bridewells.
2.The necessity of amending the Act of the 1 Vict. Cap. 27. [Dangerous Lunatic Act 1838], which appears, on the Authority of the Lord Chancellor of Ireland, to have led to the most serious abuse.165
3.The inexpedience of appropriating the Union Workhouses as places either for the custody or the treatment of the insane, for both which purposes they appear wholly unsuited.
4.The necessity of providing one central establishment for criminal lunatics, under the immediate control and direction of the government of Ireland, to be supported from the same funds and under the system adopted in respect to criminal lunatics in England.
5.The necessity of increasing the accommodation for pauper lunatics in Ireland, and of providing for the cases of epilepsy, idiocy and chronic disease, by an increased number of the District Asylums, by an enlargement of those asylums, or by the erection of separate establishments specially appropriated for these classes of patients.166
Following its completion, Lord Eliot, the Chief Secretary, sent the select committee’s report to the governors of the District Asylums, seeking their comments. The report was discussed by the governors of the Richmond District Asylum, Dublin on 3 January 1844 and, while they supported the call for asylums for criminal lunacy, epilepsy, idiocy and chronic insanity, the Richmond governors suggested that, since these measure would take time, District Asylums should be offered some measure of relief by permitting the admission of harmless and chronic patients into workhouses.167
Overall, however, the 1843 select committee saw expanding the public asylum system as the key solution to the problems presented by the mentally ill, recommending more public asylums, larger asylums and specialist asylums for certain groups of patients.168 This was a familiar response to the problems presented by the mentally ill and it defined public mental health services in Ireland for almost a century after the 1843 report. The ‘criminally insane’ were one of the groups most affected by this trend and these are considered next.
Central Criminal Lunatic Asylum (Ireland) Act 1845: Insanity and Criminal Responsibility
The idea of reduced criminal responsibility among the mentally ill and intellectually disabled has a long history
